Julia Newton

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Julia L. Newton is a Clinical Professor of Ageing and Medicine at the University of Newcastle in the United Kingdom. She has published a number of ME/CFS studies focusing on autonomic nervous system dysfunction[1] and the role of inflammation in fatigue. She is a member of the UK CFS/ME Collaborative and is the Joint Medical Adviser of the charity Action for ME.

She is Director of the Newcastle Fatigue Research Group [2] and Associate Medical Director for Research for Newcastle upon Tyne Hospitals NHS Foundation Trust.

Dr. Newton serves on the editorial board of the journal, Fatigue: Biomedicine, Health & Behavior, published on behalf of the IACFS/ME.[3]

Notable studies[edit | edit source]

Talks and interviews[edit | edit source]

Talks for Dutch ME/CFS Society

2014, Playlist on YouTube containing:

Invest in ME International ME Conferences

  • 2008, Speaker at the 3rd Invest in ME International ME Conference on Autonomic Dysfunction: Identification of aetiologically distinct subject groups within ME/CFS[53]DVD available
  • 2014, Speaker at the 9th Invest in ME International ME Conference [54]DVD available

Learn more[edit | edit source]

Online presence[edit | edit source]

References[edit | edit source]

  1. ↑ "Staff Profile - Institute of Cellular Medicine - Newcastle University". www.ncl.ac.uk. Retrieved Aug 10, 2018. 
  2. ↑ "Fatigue Research - Faculty of Medical Sciences - Newcastle University". www.ncl.ac.uk. Retrieved Aug 10, 2018. 
  3. ↑ "Fatigue: Biomedicine, Health & Behavior". www.tandfonline.com. Retrieved Nov 1, 2019. 
  4. ↑ Hoad, A.; Spickett, G.; Elliott, J.; Newton, J. (2008). "Postural orthostatic tachycardia syndrome is an under-recognized condition in chronic fatigue syndrome". QJM: monthly journal of the Association of Physicians. 101 (12): 961–965. doi:10.1093/qjmed/hcn123. ISSN 1460-2393. PMID 18805903. 
  5. ↑ Newton, Julia L.; Sheth, Amish; Shin, Jane; Pairman, Jessie; Wilton, Katharine; Burt, Jennifer A.; Jones, David E. J. (Apr 2009). "Lower Ambulatory Blood Pressure in Chronic Fatigue Syndrome". Psychosomatic Medicine. 71 (3): 361–365. doi:10.1097/psy.0b013e31819ccd2a. ISSN 0033-3174. 
  6. ↑ Hollingsworth, Kieren G.; Jones, David E. J.; Taylor, Roy; Blamire, Andrew M.; Newton, Julia L. (May 17, 2010). "Impaired cardiovascular response to standing in Chronic Fatigue Syndrome". European Journal of Clinical Investigation. 40 (7): 608–615. doi:10.1111/j.1365-2362.2010.02310.x. ISSN 0014-2972. 
  7. ↑ Newton, JL; Mabillard, H; Scott, A; Hoad, A; Spickett, G (Dec 1, 2010). "The Newcastle NHS Chronic Fatigue Syndrome Service: not all fatigue is the same" (PDF). The Journal of the Royal College of Physicians of Edinburgh. 40 (4): 304–307. doi:10.4997/jrcpe.2010.404. ISSN 1478-2715. 
  8. ↑ Jones, David E. J.; Hollingsworth, Kieren G.; Jakovljevic, Djordje G.; Fattakhova, Gulnar; Pairman, Jessie; Blamire, Andrew M.; Trenell, Michael I.; Newton, Julia L. (2011), "Loss of capacity to recover from acidosis on repeat exercise in chronic fatigue syndrome: a case–control study", European Journal of Clinical Investigation, 42 (2), doi:10.1111/j.1365-2362.2011.02567.x 
  9. ↑ Hollingsworth, KG; Hodgson, T; MacGowan, GA; Blamire, AM; Newton, JL (2012), "Impaired cardiac function in chronic fatigue syndrome measured using magnetic resonance cardiac tagging", Journal of Internal Medicine, 271: 264–270, doi:10.1111/j.1365-2796.2011.02429.x 
  10. ↑ Frith, J.; Zalewski, P.; Klawe, J. J.; Pairman, J.; Bitner, A.; Tafil-Klawe, M.; Newton, J. L. (Sep 1, 2012). "Impaired blood pressure variability in chronic fatigue syndrome—a potential biomarker". QJM: An International Journal of Medicine. 105 (9): 831–838. doi:10.1093/qjmed/hcs085. ISSN 1460-2725. 
  11. ↑ He, Jiabao; Hollingsworth, Kieren G.; Newton, Julia L.; Blamire, Andrew M. (2013), "Cerebral vascular control is associated with skeletal muscle pH in chronic fatigue syndrome patients both at rest and during dynamic stimulation", NeuroImage: Clinical, 2: 168-173, doi:10.1016/j.nicl.2012.12.006 
  12. ↑ Jason, LA; Brown, A; Evans, M; Sunnquist, M; Newton, JL (2013), "Contrasting chronic fatigue syndrome versus myalgic encephalomyelitis/chronic fatigue syndrome", Fatigue: Biomedicine, Health & Behavior, 1 (3): 168-183, doi:10.1080/21641846.2013.774556 
  13. ↑ Gotts, Z.M.; Ellis, J. G.; Newton, Julia L.; Deary, V. (2014), "The role of sleep in chronic fatigue syndrome: a narrative review", Fatigue: Biomedicine, Health & Behavior, 2 (3): 163-184, doi:10.1080/21641846.2014.935607 
  14. ↑ Robinson, L. J., Durham, J., MacLachlan, L. L., & Newton, J. L. (2015). Autonomic function in chronic fatigue syndrome with and without painful temporomandibular disorder. Fatigue: Biomedicine, Health & Behavior, 3(4), 205-219.
  15. ↑ Jason, L.A.; Sunnquist, M.; Brown, A.; Newton, J.L.; Strand, E.B.; Vernon, S.D. (2015), "Chronic fatigue syndrome versus systemic exertion intolerance disease", Fatigue: Biomedicine, Health & Behavior, 3 (3): 127-141, doi:10.1080/21641846.2015.1051291 
  16. ↑ Jason, Leonard A; Sunnquist, Madison; Brown, Abigail; Furst, Jacob; Cid, Marjoe; Farietta, Jillianna; Kot, Bobby; Bloomer, Craig; Nicholson, Laura; Williams, Yolonda; Jantke, Rachel; Newton, Julia L; Strand, Elin Bolle (2015), "Factor Analysis of the DePaul Symptom Questionnaire: Identifying Core Domains", Journal of Neurology and Neurobiology, 1 (4), doi:10.16966/2379-7150.114 
  17. ↑ Brown, Audrey E.; Jones, David E.; Walker, Mark; Newton, Julia L. (2015), "Abnormalities of AMPK Activation and Glucose Uptake in Cultured Skeletal Muscle Cells from Individuals with Chronic Fatigue Syndrome", PLoS One, 10 (4), doi:10.1371/journal.pone.0122982 
  18. ↑ Jason, LA; Kot, B; Sunnquist, M; Brown, A; Reed, J; Furst, J; Newton, JL; Strand, EB; Vernon, SD (2015), "Comparing and Contrasting Consensus versus Empirical Domains", Fatigue: biomedicine, health & behavior, 3 (2): 63-74, doi:10.1080/21641846.2015.1017344, PMID 26977374 
  19. ↑ Rutherford, Gina; Manning, Philip; Newton, Julia L. (2016), "Understanding Muscle Dysfunction in Chronic Fatigue Syndrome", Journal of Aging Research, doi:10.1155/2016/2497348 
  20. ↑ Gotts, Zoe; Deary, Vincent; Newton, Julia; Ellis, Jason (2016), "Treatment of insomnia reduces fatigue in chronic fatigue syndrome in those able to comply with the intervention", Fatigue: Biomedicine, Health & Behavior, 4 (4): 208-216, doi:10.1080/21641846.2016.1222699 
  21. ↑ Pendergrast, Tricia; Brown, Abigail; Sunnquist, Madison; Jantke, Rachel L.; Newton, Julia L.; Strand, Elin Bolle; Jason, Leonard A. (2016), "Housebound versus nonhousebound patients with myalgic encephalomyelitis and chronic fatigue syndrome", Chronic Illness, doi:10.1177/1742395316644770 
  22. ↑ Thorpe, Taylor; McManimen, Stephanie; Gleason, Kristen; Stoothoff, Jamie; Newton, Julia L.; Strand, Elin Bolle; Jason, Leonard A. (2016), "Assessing current functioning as a measure of significant reduction in activity level", Fatigue: Biomedicine, Health & Behavior, 4 (3): 175-188, doi:10.1080/21641846.2016.1206176 
  23. ↑ Kidd, Elizabeth; Brown, Abigail; McManimen, Stephanie; Jason, Leonard A.; Newton, Julia L.; Strand, Elin B. (2016), "The Relationship between Age and Illness Duration in Chronic Fatigue Syndrome", Diagnostics, 6 (2): 16, doi:10.3390/diagnostics6020016 
  24. ↑ Newton, Julia L.; Finkelmeyer, Andreas; Petrides, George; Frith, James; Hodgson, Tim; Maclachlan, Laura; MacGowan, Guy; Blamire, Andrew M. (2016), "Reduced cardiac volumes in chronic fatigue syndrome associate with plasma volume but not length of disease: a cohort study", Open Heart, 3 (1), doi:10.1136/openhrt-2015-000381 
  25. ↑ Clark, James E.; Ng, W. Fai; Watson, Stuart; Newton, Julia L. (2016), "The aetiopathogenesis of fatigue: unpredictable, complex and persistent", British Medical Bulletin, 2016 (117): 139–148, doi:10.1093/bmb/ldv057 
  26. ↑ Gotts, Z.M.; Deary, V.; Newton, Julia L.; Ellis, J. G. (2016), "A comparative polysomnography analysis of sleep in healthy controls and patients with chronic fatigue syndrome.", Fatigue: Biomedicine, Health & Behavior, 4 (2): 80-93, doi:10.1080/21641846.2016.1167470 
  27. ↑ Jason, L. A.; McManimen, S.; Sunnquist, Madison; Brown, A.; Furst, J.; Newton, J. L.; Strand, E. B. (2016), "Case definitions integrating empiric and consensus perspectives", Fatigue: Biomedicine, Health & Behavior, 4 (1): 1-23, doi:10.1080/21641846.2015.1124520 
  28. ↑ Jason, Leonard A; Sunnquist, Madison; Brown, Abigail; Evans, Meredyth; Newton, Julia L (2016), "Are Myalgic Encephalomyelitis and chronic fatigue syndrome different illnesses? A preliminary analysis", Journal of Health Psychology, 21 (1): 3-15, doi:10.1177/1359105313520335 
  29. ↑ Jason, Leonard A; McManimen, Stephanie; Sunnquist, Madison; Newton, Julia L; Strand, Elin Bolle (2017), "Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia", ECronicon, 5 (1): 19-28, PMID 28713879 
  30. ↑ Maclachlan, Laura; Watson, Stuart; Gallagher, Peter; Finkelmeyer, Andreas; Jason, Leonard A.; Sunnquist, Madison; Newton, Julia L. (2017), "Are current chronic fatigue syndrome criteria diagnosing different disease phenotypes?", PLOS One, doi:10.1371/journal.pone.0186885 
  31. ↑ Tomas, Cara; Finkelmeyer, Andreas; Hodgson, Tim; MacLachlan, Laura; MacGowan, Guy A; Blamire, Andrew M; Newton, Julia L (2017), "Elevated brain natriuretic peptide levels in chronic fatigue syndrome associate with cardiac dysfunction: a case control study", Open Heart, doi:10.1136/openhrt-2017-000697 
  32. ↑ Strassheim, Victoria; Lambson, Rebecca; Hackett, Katie L.; Newton, Julia L. (Jul 3, 2017). "What is known about severe and very severe chronic fatigue syndrome? A scoping review". Fatigue: Biomedicine, Health & Behavior. 5 (3): 167–183. doi:10.1080/21641846.2017.1333185. ISSN 2164-1846. 
  33. ↑ Jason, LA; McManimen, S; Sunnquist, M; Newton, JL; Strand, EB (2017), "Clinical criteria versus a possible research case definition in chronic fatigue syndrome/myalgic encephalomyelitis", Fatigue: biomedicine, health & behavior, doi:10.1080/21641846.2017.1299077 
  34. ↑ Davidson, Sean L.; Gotts, Zoe M.; Ellis, Jason G.; Newton, Julia L. (Mar 2017), "Two year follow-up of sleep diaries and polysomnography in chronic fatigue syndrome: a cohort study", Fatigue: Biomedicine, Health & Behavior, doi:10.1080/21641846.2017.1297280 
  35. ↑ O’connor, Kelly; Sunnquist, Madison; Nicholson, Laura; Jason, Leonard A; Newton, Julia L; Strand, Elin B (Dec 12, 2017). "Energy envelope maintenance among patients with myalgic encephalomyelitis and chronic fatigue syndrome: Implications of limited energy reserves". Chronic Illness: 174239531774647. doi:10.1177/1742395317746470. ISSN 1742-3953. PMID 29231037. 
  36. ↑ Tomas, Cara; Brown, Audrey; Strassheim, Victoria; Elson, Joanna; Newton, Julia; Manning, Philip (Oct 24, 2017). "Cellular bioenergetics is impaired in patients with chronic fatigue syndrome". PLOS ONE. 12 (10): e0186802. doi:10.1371/journal.pone.0186802. ISSN 1932-6203. PMID 29065167. 
  37. ↑ Schoeman, Elizna M.; Van Der Westhuizen, Francois H.; Erasmus, Elardus; van Dyk, Etresia; Knowles, Charlotte V. Y.; Al-Ali, Shereen; Ng, Wan-Fai; Taylor, Robert W.; Newton, Julia L. (Mar 16, 2017). "Clinically proven mtDNA mutations are not common in those with chronic fatigue syndrome". BMC Medical Genetics. 18 (1). doi:10.1186/s12881-017-0387-6. ISSN 1471-2350. PMID 28302057. 
  38. ↑ Zalewski, Pawel; Finkelmeyer, Andreas; Frith, James; Maclachlan, Laura; Blamire, Andrew; Newton, Julia L. (2018). "Liver volume is lower and associates with resting and dynamic blood pressure variability in chronic fatigue syndrome". Fatigue: Biomedicine, Health & Behavior. 6 (3): 141-152. doi:10.1080/21641846.2018.1488525. 
  39. ↑ Tomas, Cara; Newton, Julia L (2018), "Metabolic abnormalities in chronic fatigue syndrome/myalgic encephalomyelitis: a mini-review", Biochemical Society Transactions, doi:10.1042/BST20170503, PMID 29666214 
  40. ↑ Brown, Audrey E; Dibnah, Beth; Fisher, Emily; Newton, Julia L; Walker, Mark (2018), "Pharmacological activation of AMPK and glucose uptake in cultured human skeletal muscle cells from patients with ME/CFS", Bioscience Reports, doi:10.1042/BSR20180242 
  41. ↑ Strassheim, Victoria; Welford, Jenny; Ballantine, Rob; Newton, Julia L. (Dec 2018). "Managing fatigue in postural tachycardia syndrome (PoTS): The Newcastle approach". Autonomic Neuroscience. 215: 56–61. doi:10.1016/j.autneu.2018.02.003. 
  42. ↑ Clark, James E.; Davidson, Sean L.; Maclachlan, Laura; Newton, Julia L.; Watson, Stuart (2017), "Rethinking childhood adversity in chronic fatigue syndrome", Fatigue: Biomedicine, Health & Behavior, doi:10.1080/21641846.2018.1384095 
  43. ↑ Finkelmeyer, Andreas; He, Jiabao; Maclachlan, Laura; Watson, Stuart; Gallagher, Peter; Newton, Julia L.; Blamire, Andrew M. (2018), "Grey and white matter differences in Chronic Fatigue Syndrome – A voxel-based morphometry study", NeuroImage: Clinical, 17: 24-30, doi:10.1016/j.nicl.2017.09.024, PMID 29021956 
  44. ↑ Lynn, Megan; Maclachlan, Laura; Finkelmeyer, Andreas; Clark, James; Locke, James; Todryk, Stephen; Ng, Wan-Fai; Newton, Julia L.; Watson, Stuart (2018). "Reduction of glucocorticoid receptor function in Chronic Fatigue Syndrome". Mediators of Inflammation. doi:10.1155/2018/3972104. 
  45. ↑ Strassheim, Victoria Jane; Sunnquist, Madison; Jason, Leonard A.; Newton, Julia L. (Sep 1, 2018). "Defining the prevalence and symptom burden of those with self-reported severe chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME): a two-phase community pilot study in the North East of England". BMJ Open. 8 (9): e020775. doi:10.1136/bmjopen-2017-020775. ISSN 2044-6055. PMID 30232103. 
  46. ↑ Venter, Marianne; Tomas, Cara; Pienaar, Ilse S.; Strassheim, Victoria; Erasmus, Elardus; Ng, Wan-Fai; Howell, Neil; Newton, Julia L.; Van der Westhuizen, Francois H. (Dec 2019). "MtDNA population variation in Myalgic encephalomyelitis/Chronic fatigue syndrome in two populations: a study of mildly deleterious variants". Scientific Reports. 9 (1). doi:10.1038/s41598-019-39060-1. ISSN 2045-2322. PMID 30814539. 
  47. ↑ Robinson, Lucy J.; Gallagher, Peter; Watson, Stuart; Pearce, Ruth; Finkelmeyer, Andreas; Maclachlan, Laura; Newton, Julia L. (Feb 5, 2019). "Impairments in cognitive performance in chronic fatigue syndrome are common, not related to co-morbid depression but do associate with autonomic dysfunction". PLOS ONE. 14 (2): e0210394. doi:10.1371/journal.pone.0210394. ISSN 1932-6203. 
  48. ↑ Słomko, Joanna; Newton, Julia L; Kujawski, Sławomir; Tafil-Klawe, Małgorzata; Klawe, Jacek; Staines, Donald; Marshall-Gradisnik, Sonya; Zalewski, Pawel (Mar 2019). "Prevalence and characteristics of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) in Poland: a cross-sectional study". BMJ Open. 9 (3): e023955. doi:10.1136/bmjopen-2018-023955. ISSN 2044-6055. PMID 30850404. 
  49. ↑ Tomas, Cara; Brown, Audrey E.; Newton, Julia L.; Elson, Joanna L. (Mar 1, 2019). "Mitochondrial complex activity in permeabilised cells of chronic fatigue syndrome patients using two cell types". PeerJ. 7: e6500. doi:10.7717/peerj.6500. ISSN 2167-8359. PMID 30847260. 
  50. ↑ Strassheim, Victoria; Deary, Vincent; Webster, Deborah A.; Douglas, Jane; Newton, Julia L.; Hackett, Katie L. (Jul 9, 2019). "Conceptualizing the benefits of a group exercise program developed for those with chronic fatigue: a mixed methods clinical evaluation". Disability and Rehabilitation: 1–11. doi:10.1080/09638288.2019.1636315. ISSN 0963-8288. 
  51. ↑ Morten, Karl J.; Newton, Julia L.; Joanna L. Elson; Potter, Michelle; Lodge, Tiffany A.; Tomas, Cara (Aug 7, 2019). "Assessing cellular energy dysfunction in CFS/ME using a commercially available laboratory test". Scientific Reports. 9 (1): 1–9. doi:10.1038/s41598-019-47966-z. ISSN 2045-2322. 
  52. ↑ "Standing up for Fatigue - Professor Julia Newton and Professor Jason Ellis". Retrieved Aug 10, 2018. 
  53. ↑ Research, Invest in ME. "Invest in ME Research - IIMEC3". www.investinme.eu. Retrieved Aug 10, 2018. 
  54. ↑ Research, Invest in ME. "Invest in ME Research - IIMEC9 International ME Conference 2014". www.investinme.eu. Retrieved Aug 10, 2018. 

chronic fatigue syndrome (CFS) - A controversial term, invented by the U.S. Centers for Disease Control, that generally refers to a collection of symptoms as “fatigue”. There have been multiple attempts to come up with a set of diagnostic criteria to define this term, but few of those diagnostic criteria are currently in use. Previous attempts to define this term include the Fukuda criteria and the Oxford criteria. Some view the term as a useful diagnostic category for people with long-term fatigue of unexplained origin. Others view the term as a derogatory term borne out of animus towards patients. Some view the term as a synonym of myalgic encephalomyelitis, while others view myalgic encephalomyelitis as a distinct disease.

chronic fatigue syndrome (CFS) - A controversial term, invented by the U.S. Centers for Disease Control, that generally refers to a collection of symptoms as “fatigue”. There have been multiple attempts to come up with a set of diagnostic criteria to define this term, but few of those diagnostic criteria are currently in use. Previous attempts to define this term include the Fukuda criteria and the Oxford criteria. Some view the term as a useful diagnostic category for people with long-term fatigue of unexplained origin. Others view the term as a derogatory term borne out of animus towards patients. Some view the term as a synonym of myalgic encephalomyelitis, while others view myalgic encephalomyelitis as a distinct disease.

systemic exertion intolerance disease (SEID) - A term for ME/CFS that aims to avoid the stigma associated with the term "chronic fatigue syndrome", while emphasizing the defining characteristic of post-exertional malaise (PEM). SEID was defined as part of the diagnostic criteria put together by the Institute of Medicine (IOM) report of 10 February 2015.

myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

ME/CFS - An acronym that combines myalgic encephalomyelitis with chronic fatigue syndrome. Sometimes they are combined because people have trouble distinguishing one from the other. Sometimes they are combined because people see them as synonyms of each other.

myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

chronic fatigue (CF) - Persistent and abnormal fatigue is a symptom, not an illness. It may be caused by depression, multiple sclerosis, fibromyalgia, chronic fatigue syndrome or many other illnesses. The term "chronic fatigue" should never be confused with the disease chronic fatigue syndrome.

ME/CFS - An acronym that combines myalgic encephalomyelitis with chronic fatigue syndrome. Sometimes they are combined because people have trouble distinguishing one from the other. Sometimes they are combined because people see them as synonyms of each other.

myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

BMJ - The BMJ (previously the British Medical Journal) is a weekly peer-reviewed medical journal.

myalgic encephalomyelitis (ME) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.

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